Case Study

Rewriting the Story: Entering the World of the Abused Child

By Dan Hughes

Sadly, children who’ve suffered abuse and neglect at the hands of their parents are often convinced that their mistreatment was justified. As a result, they typically grow up with a pervasive sense of shame, struggling with emotional regulation, cognitive and reflective functioning, and the inability to experience positive emotions. It isn’t surprising, then, that these children are often unlikely to be cooperative participants in therapy or easily engaged with new parents and teachers.

Therapists must therefore work to discover the children under the symptoms—those who lived before the abuse, who survived in the face of it, and who can begin to emerge after being accepted and embraced by those who’ve come to love them. To have a positive impact on these children, caretakers and therapists must offer them a different felt experience of who they are. As Daniel Stern, Colwyn Trevarthen, and other child psychologists have shown us over the past 30 years, the most powerful means of achieving this is through congruently communicating, both verbally and nonverbally, how they see these children and mirroring the children’s emotional experiences. That process is called intersubjectivity, and it’s the primary way that children develop a stable representation of self. For example, parents who communicate anger and indifference raise children who experience themselves as bad and unlovable. If those children are to change their primary experience of themselves, they need parents—and possibly therapists—who express the experience of joy that they’ve brought into the world, love for their previously unseen selves, and admiration for their perseverance.

Jake’s Story

Jake was 9 years old when he first came to see me. He’d had a rough start in life, full of physical, emotional, and verbal abuse, mostly from his father, while his mother looked the other way so that she wouldn’t be abused also. At age 4, he was put in foster care and moved twice until, at age 8, he was adopted by Peter and Stephanie. After a few months of relative calm, he began to exhibit the behaviors that had been common in his three previous foster homes. He argued a great deal, seldom acknowledged being in the wrong, and never expressed any kind of sadness, fear, or regret. His hair-trigger temper often resulted in long bouts of screaming and swearing, especially at Stephanie. Although he had some interests, especially riding his bike and constructing elaborate Lego buildings, he didn’t seem to enjoy engaging in many other activities. In fact, Peter reported that if they spent the day together building something or swimming, at the end of the day, Jake would complain that he hadn’t had any fun and would seem preoccupied with the one incident that didn’t go his way.

When children come into therapy with me, I seek to discover how they formulate their own life stories, knowing that much of what I’m likely to hear about them initially comes from others, especially their parents. My goal as a therapist is to help children begin to more actively become the authors of their own stories, increasingly aware of their own possibilities, hopes, and dreams. To do that, I try to help them reexperience their lives as I communicate my support and my emotional responses to the events we discuss, including my sadness and compassion for the hard parts of their stories, my joy and excitement for their courage and perseverance, and my interest in their strengths and vulnerabilities.

As I get to know more about their inner lives, I give expression to my discoveries, although these expressions are mostly nonverbal—a sympathetic modulation in my voice, or a change in the look on my face, that indicates my connection with them. As they sense my affective responses, they begin to experience a new, more positive sense of self, which gives them a solider foundation to move forward in life’s journey. The possibility of moving past the old terror and shame opens up for them.

My first sessions with children usually feature a relaxed, rhythmic dialogue as I wonder about this and that and get engaged with whatever is on their mind, always curious about what it means to them. I also gently introduce difficult topics that they might initially avoid, accepting whatever they say or don’t say about them. In this way, I make sure they feel safe in the knowledge that there’s nothing in their story or inner life that would cause me to judge them or see them as “wrong.”

Initially, my sessions with Jake included both of his parents, but only Peter, his adoptive father, could attend our fifth session with him. In this session, I asked Jake if he recalled what event had brought him into foster care when he was 4 years old. He was unsure and agreed to hear what the social worker had told me. Jake had been at home with his biological father, Stan, and had been running around, showing off for a neighbor sitting with his father at the kitchen table, when he’d accidentally bumped the table, spilling coffee on his father. His father had jumped up, sworn at Jake, and slapped him so hard across the face that he’d fallen to the floor. His father had kept screaming as he dragged Jake into the hall closet and locked the door. When the neighbor challenged Stan’s behavior, Stan threw him out of the house, at which point the neighbor called the police. The police arrived an hour later to find Jake still locked in the closet. When Stan refused to cooperate with them, they took Jake to the social worker’s office, and from there he went into foster care. In the end, his parents refused to accept the services offered to enable Jake to return home, so he was eventually adopted.

When I asked Jake how he made sense of what happened, he replied simply, “I was bad.”

I suggested instead that the judge placed him in foster care not because he was bad, but because his father had abused him. Jake replied that his father wouldn’t have abused him if he hadn’t been bad. As often happens with abused children, Jake had incorporated his father’s reaction to him as an objective reality and a self-judgment.

Rather than try to argue with Jake that he wasn’t bad, I allowed myself to feel what I sensed he’d experienced, and I communicated it back to him. “Wait a second, Jake,” I said. “I’m trying to imagine what happened. You were 4 years old! A little fellow, tiny—not big like you are now. You were excited that this nice neighbor was giving you a lot of attention, running around and having a good time being silly. Four-year-olds are often that way. And you were running, and you bumped the table, and the coffee spilled on your dad, and you heard your dad screaming at you. Your dad! And you probably wanted to say, ‘I’m sorry, dad! I didn’t mean to do it!’ But you might not have been able to say that because he hit you with his big hand, and you fell on the floor.”